L'Hormona adrenocorticòtropa plasmàtica en el període postoperatori immediat com a índex predictor de la curació de la malaltia de Cushing Authors Carles Villabona Abstract A plasma cortisol less than 50 nmol/l in the early postoperative stage after transsphenoidal surgery for Cushings disease has been proposed as predictive of cure. Data on postoperative plasma adrenocorticotropin (ACTH) are scarce. The purpose of this study was to establish whether plasma ACTH in the early postoperative period after transsphenoidal surgery for Cushings disease can predict cure and to compare its prognostic value with that of plasma cortisol. We analysed thirteen patients with Cushings disease (mean age forty-three years) treated with transsphenoidal surgery. Plasma cortisol andACTHsamples were taken in the first seven days after surgery. Follow-up was between twelve and fifty-five months (mean thirtyfour months). During this time samples for basal plasma cortisol and after stimulation with 250 µg of ACTH1-24, basal plasma ACTH, 24 hours free urinary cortisol and low-dose suppression with dexametasone (0,5 mg/6 h for two days) were taken periodically to evaluate their clinical status. Twelve patients (92,3 %) were in remission during follow-up. The early postoperative cortisol level was 50 nmol/l or less in only four of the twelve patients in remission, while the ACTH level was 2 pmol/l or less in six of these patients. Normal values for ACTH are between 2 and 12 pmol/l. The value of plasma ACTH levels measured in the first postoperative week is not a better predictor of cure than early postoperative plasma cortisol level. A very low plasma ACTH level can not predict cure. Downloads Text complet (Català) Published 2007-12-28 Issue 56, 2005 : Endocrinologia molecular / Jaume Reventós editor Section Articles License The intellectual property of the articles belongs to the respective authors. At the time of submitting the articles to Treballs de la Societat Catalana de Biologia, authors accept the following terms: — Authors assign to the SCB (a subsidiary of the Institut d’Estudis Catalans) the rights of reproduction, public communication (including communication through social networks) and distribution of the articles submitted for publication to Treballs de la Societat Catalana de Biologia, in any form and medium, including digital platforms. The Publications Committee reserves the right to accept or refuse submitted articles and the right to make any editorial changes it deems appropriate. If the suggested changes are accepted by authors, they should re-submit the article with such changes. — Authors answer to the SCB for the authorship and originality of submitted articles. In other words, authors assure that submitted articles do not contain fragments of works by other authors or fragments of their own previously published works; that the content of articles is original, and that the copyright of third parties is not infringed upon. Authors accept this responsibility and undertake to hold harmless the SCB for any loss or damage resulting from non-compliance with this obligation. Furthermore, they should include a statement in articles submitted to the journal regarding their responsibility for the content of the articles. — Authors are responsible for obtaining permission for the reproduction of all graphic material included in articles, and they should moreover ensure that images, videos, etc., have been created with the consent of the individuals appearing in them, and that material belonging to third parties is clearly identified and acknowledged as such within the text. Likewise, authors should provide the respective consents and authorisations to the SCB when submitting articles. — The SCB is exempt from any liability arising from the possible infringement of intellectual property rights by authors. In all cases, it undertakes to publish corrections, clarifications, retractions and apologies, if necessary. — Unless otherwise stated in the text or in the graphic material, the contents published in the journal are subject to an Attribution - NonCommercial - NoDerivs 3.0 Spain (by-nc-nd) license from Creative Commons, the full text of which may be consulted at https://creativecommons.org/licenses/by-nc-nd/3.0/es/deed.en. Therefore, the general public is authorised to reproduce, distribute and communicate articles as long as their authorship and publishing entity are acknowledged, and no commercial use is made of them nor derivative work produced from them. — The journal is not responsible for the ideas and opinions expressed by the authors of published articles.
